Manager, Special Investigations – Recovery

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Skyward Specialty Insurance

WebsiteLinkedInAll Job Openings

501 - 1000 employees

Founded 2007

🤝 B2B

💸 Finance

⚕️ Healthcare Insurance

💰 $177.3M Post-IPO Secondary - Skyward Specialty on 2024-05

B2B • Finance • Healthcare Insurance

Skyward Specialty Insurance is a Houston-based specialty insurance group that provides tailored risk solutions across niche and complex markets. The company offers a range of specialty insurance products including transactional Excess & Surplus (E&S), professional lines, medical stop-loss, surety, captives, programs, global property, agriculture & credit (re)insurance, and risk consulting. Skyward works primarily with brokers and agents, leverages technology (including e-surety capabilities) to deliver innovative underwriting and claims services, and focuses on high-complexity, non-standard risks and scalable specialty solutions.

📋 Description

• Overseeing the company’s fraud detection, subrogation, and recovery functions • Coordinating all potential fraud investigations and ensuring compliance with state-level SIU reporting requirements • Using traditional and AI-based fraud detection indicators and other investigative tools • Partnering with adjusters and claims managers to evaluate concerns, determine appropriate investigative strategies, and assign cases to third-party vendors • Reviewing and interpreting claims data and data from third-party vendors to make recommendations for improvements in investigations, processes and outcomes • Using ISO data and predictive models to proactively conduct and/or facilitate additional investigation on claims • Assigning investigative fieldwork to third-party vendors and overseeing vendor performance, quality, and compliance • Completing and/or contributing state-level SIU statistical reporting functions in conjunction with compliance department personnel • Providing consultative support to claims staff regarding fraud detection, subrogation, and recovery opportunities • Reviewing vendor investigative findings and preparing or validating reports summarizing conclusions and recommendations • Coordinating with legal, compliance, underwriting, and law enforcement/regulatory agencies when necessary • Developing and facilitating training and awareness initiatives to strengthen fraud prevention capabilities across the claims team • Seeking out new vendors with insightful data sources and technology solutions that help identify fraud or questionable claim indicators • Performing other duties as assigned.

🎯 Requirements

• 10+ years of commercial insurance claims experience, including direct handling of litigation caseloads • 3+ years of leadership experience preferred • Strong background in claims handling, fraud detection, and subrogation with proven ability to evaluate complex claims • Strong knowledge of Claims investigation laws and regulations • Bachelor's degree (or equivalent experience) • Demonstrated proficiency in current fraud analytics, technology and investigative tools (e.g., ISO, Carpe Data, or similar) • Knowledge of SIU regulatory requirements and state-level statistical reporting obligations • Experience managing or coordinating third-party investigative vendors • Excellent analytical, critical thinking, and problem-solving skills • Strong communication and collaboration skills, including ability to influence decision-making across claims teams.

🏖️ Benefits

• health and welfare benefits • tuition and professional certification assistance • 401k savings • elective participation in the Employee Stock Purchase Program • paid time off • paid holidays • child bonding leave • other employee assistance